Globalization and Extinction

I recently read two books that both have a powerful “wow” factor, which has kept them on my mind. In thinking about them some more, it also seems that there are some connections to medicine that could also be quite profound.

The first book is The Second Machine Age, written by two MIT economists. The central thesis of the book is that we are at the dawn of a new age of human existence, comparable in its ramifications to the changes wrought by the first machine age — the industrial revolution – which was sparked by the invention of the steam engine. Just as the steam engine made it possible to do more physical work than could be done by the muscles of people or animals, the advances in information technology now make it possible to do more cognitive work than humans alone can do (think of Watson playing Jeopardy, computers routinely beating grandmasters at chess, or Google’s driverless car. The steam engine caused an “inflection point” in the history of civilization and “made the modern world possible.” The authors make a compelling case that we are in the midst of another inflection point, with a dramatically different world right around the corner.

The second book is The Sixth Extinction, which draws its title from the history of life on earth. Over geologic time, there have been 5 “mass extinction events” that are marked by sharp drops in biodiversity in the fossil record. The most recent of these is also the most familiar. About 65 million years ago a large asteroid smacked into the earth, inducing catastrophic global environmental changes that doomed the dinosaurs (and lots of other kinds of animals and plants). As in the first book, the author makes a compelling case that we are in the middle of another momentous event in the history of the world, in this case another mass extinction event. Unlike the last extinction, this one is being caused by the impact of humans, not extraterrestrial rocks, and is mediated by climate change, habitat destruction and the dispersion of species into non-native habitats. It is a pretty grim read.

So what is the connection to medicine?

The technology explosion described in the first book is facilitating medical diagnosis and treatment across physical boundaries. Extending medical talent across borders this way reminds me a bit of what happens when species are transported from one habitat to another, which was discussed in the second book. In both cases, the “locals” face a new and often overwhelming challenge from the interloper. The rapid development of the technology for remote monitoring, machine-based diagnostics and robotic therapeutics means that the old adage that “all health care is local” will soon be an anachronism. Local providers had better adapt, or they’ll end up like the dinosaurs.

One thought on “Globalization and Extinction

  1. I agree, but I don’t like it too much. I’m in remission, but I’m told that my incurable-aggressive cancer probably will come back in a few years. I’m also 72. I just want a TSH run to control my thyroid. I want my stomach med for my IBS-it is nice not to be in the ER-Navy and AF gastroenterologists told me that it was doubtful that I’d reach 50. I think that if I get a sinus infection that I should be treated for that. The last one, the drainage was opening up the surgery sites inside my nose-and the PCP didn’t take it seriously, he didn’t think that I should have follow up-we got into a fight-my BP went up-The oncologist that I contacted-and told me to go to the PCP-contacted him-and gave him the facts about oncology and HMO cost control. When I went back, the PCP wasn’t dismissive and actually acted like he gave a damn.

    I don’t want to be micromanaged about my BP. My oncologists-both-called my PCP and told him to accept the new BP guidelines. With all of the fighting and fussing, my BP was going up. No, I don’t want to wear electronic crap like a Borg, and have every heart beat and sneeze monitored.

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